Catheter Guiding Flexible Connector

ABSTRACT

A flexible connector couples the inlet end of a tracheotomy tube inner cannula to an outlet port of an in-line catheter. The catheter exit end of the connector is adapted to be serially coupled in pneumatic communication with the inlet end of the tracheotomy tube inner cannula and also to guide the downstream tip of the catheter into the inlet end of the inner cannula in response to pushing of the catheter upstream of the catheter outlet port. Thus, the in-line catheter can be inserted into the tracheotomy tube inner cannula with little likelihood of having to compress or “flip” the connector or disconnect the connector from the tracheotomy tube and the patient from the ventilator circuit.

BACKGROUND OF THE INVENTION

This invention relates generally to tracheotomy associated equipment andmore particularly concerns flexible connectors for coupling in-linecatheters to tracheotomy tube inner cannulas.

In-line suction catheters are used to permit a patient to continuouslyrespirate through a tracheotomy tube while the catheter is inserted intothe inner cannula of the tracheotomy tube. The in-line catheter has ahousing with two inlet ports and an outlet port. A ventilator circuit isconnected to one of the housing inlet ports. The catheter extends intothe housing through the other housing inlet port. A flexible connectorcouples the housing outlet port in serial communication with the inletor ventilator end of the inner cannula. The air and catheter are pushedthrough the flexible connector into the inlet end of the cannula foradministration to the patient. The flexible connector consists of anaccordion-like tubular body with entry and exit collars on itsrespective ends taken in relation to the direction of insertion of thecatheter. The exit end of the flexible connector slips onto the entryend of the inner cannula and the entry end of the flexible connectorslips into the outlet port of the in-line catheter housing.

In-line suction catheters, as they are inserted through known flexibleconnectors into the entry end of the inner cannula, almost always hangup on the inlet face of the insertion end of the cannula. Thisinterference necessitates immediate implementation of one or moreremedial actions until the problem is resolved. Initially, the flexibleconnector is longitudinally compressed to decrease the length betweenthe tip of the in line suction catheter and the ventilator end of innercannula. If compression does not resolve the problem, the suctioncatheter is twisted and turned in an attempt to “flip” it into the entryto the inner cannula. These actions cause discomfort to the patient,lengthen the time required for completion of the procedure, waste thevaluable time of respiratory therapists and nurses and expend possiblyprecious time for the patient undergoing the procedure.

If neither compression nor “flipping” are successful, the inline suctioncatheter is eventually disconnected from the ventilator circuit. In thiscase, the procedure is further lengthened by the extra time to needed todisconnect and reassemble the ventilator circuit. More significantly,disconnection causes a loss of ventilator pressure to the patient whichcan be rapidly physiologically catastrophic, cause a loss of sterilitypossibly resulting in more infections and further subject the patient tomore stressful discomfort including the experience of a “smothering”feeling from no longer being on the ventilator. Furthermore, somepatients require the pressure created by the ventilator circuit to keeptheir airways free of fluid and allow oxygenation/ventilation to occur.Once pressure is lost, the procedure has embarked on down hill course. Adisconnect from the pressure of the ventilator circuit can result inrapid “flooding” of the alveoli with fluid, resulting in extremely quickdecompensation, perhaps in as little as the time for eight breaths. Whenthe ventilator circuit is reconnected, it can take several hours for theregained pressure to clear the alveoli of fluid. For patients who aredependent on maintenance of continued pressure, it is imperative that nodisconnects occur as the benefits of loss of pressure are quickly lostand slowly regained.

In a worst case scenario, once the connector has been removed and thein-line suction catheter has been placed directly on the inner cannula,the catheter may still hang up on the cannula entry face. In this event,it is necessary to acquire from supply and install a different type ofsuction catheter which can be passed directly into the inner cannulaentry, leaving the patient completely off the ventilator and increasingthe time and expense of the procedure and the risks and discomfort tothe patient.

It is, therefore, an object of this invention to provide a flexibleconnector which facilitates easy passage of an inline suction catheterinto a tracheotomy tube inner cannula. Another object of this inventionis to provide a flexible connector which does not require longitudinalcompression to accomplish passage of an inline suction catheter into atracheotomy tube inner cannula. A further object of this invention is toprovide a flexible connector which, even when arcuately flexed, willreadily pass an inline suction catheter into a tracheotomy tube innercannula. Yet another object of this invention is to provide a flexibleconnector which does not require twisting and turning of the suctioncatheter to “flip” the catheter into the inner cannula. It is also anobject of this invention to provide a flexible connector which reducesthe likelihood of need to disconnect the patient from the ventilator toaccomplish passage of a catheter into a tracheotomy tube inner cannula.

SUMMARY OF THE INVENTION

In accordance with the invention, a flexible connector is provided forcoupling the inlet end of a tracheotomy tube inner cannula to an outletport of an in-line catheter. The connector has an elongated, flexible,accordion-like tubular body. The catheter entry end of the tubular bodyis adapted to be serially coupled in pneumatic communication with thecatheter outlet port. The catheter exit end of the tubular body isadapted to be serially coupled in pneumatic communication with the inletend of the tracheotomy tube inner cannula and to guide the downstreamtip of the catheter into the inlet end of the inner cannula in responseto pushing of the catheter upstream of the catheter outlet port.

In a preferred embodiment of the connector, the guiding adaptation is agradual taper in a downstream direction. The taper has an inner diameterat its upstream end substantially equal to the outer diameter of theinlet end of the inner cannula and an inner diameter at its downstreamend not greater than the inner diameter of the inlet end of the innercannula. A flat wall is provided about the downstream end of the gradualtaper. The wall has a thickness substantially equal to the thickness ofthe entry end face of the inner cannula. A portion of constant diameterextends downstream from the flat wall and cooperates with the flat wallto form a cup for the entry end of the inner cannula. When the innercannula is inserted into abutment against the flat wall of the cup, thediameter of the downstream passageway of the taper is not greater thanthe diameter of the passageway into the abutting cannula, so a cathetercannot “hang up” on the cannula.

It is also preferred that the exit end of the connector have a bearingportion with an outer diameter substantially equal to the outer diameterof the cup. The bearing portion extends upstream from the upstream endof the gradual taper. A hard sleeve concentrically disposed about andspanning across the bearing portion and the cup creates a void betweenthe sleeve and the connector, but the bearing portion and cup affordsufficient contact to enable manipulation of the exit end of theconnector by manipulation of the hard sleeve. A radial expansion at theupstream end of the bearing portion and an annular rim on the downstreamend of the cup cooperate to prevent longitudinal motion of the sleeve onthe connector.

BRIEF DESCRIPTION OF THE DRAWINGS

Other objects and advantages of the invention will become apparent uponreading the following detailed description and upon reference to thedrawings in which:

FIG. 1 is a longitudinal diametric cross-sectional view of a knownflexible connector with a catheter inserted therein;

FIG. 2 is a cross-sectional view taken along the line 2-2 of FIG. 1:

FIG. 3 is a side elevation view of a preferred embodiment of a flexibleconnector in accordance with the invention;

FIG. 4 is a cross-sectional view taken along the line 4-4 of FIG. 3;

FIG. 5 is a cross-sectional view taken along the line 5-5 of FIG. 3;

FIG. 6 is a side elevation assembly view of the flexible connector ofFIG. 3 with a hard sleeve at the entry end of the connector and theentry end of a tracheotomy tube inner cannula at the exit end of theconnector;

FIG. 7 is a longitudinal diametric cross-sectional view of the assembledcomponents of FIG. 6 with a catheter inserted in the flexible connector;

FIG. 8 is a cross-sectional view taken along the line 8-8 of FIG. 7; and

FIG. 9 is a longitudinal diametric cross-sectional view of the assembledcomponents of FIG. 6 with a hard sleeve mounted on the exit end of theconnector.

While the invention will be described in connection with a preferredembodiment thereof, it will be understood that it is not intended tolimit the invention to that embodiment or to the details of theconstruction or arrangement of parts illustrated in the accompanyingdrawings.

DETAILED DESCRIPTION

Turning first to FIGS. 1 and 2, a typical known flexible connector 10 isillustrated. The connector 10 is commonly used to couple the inlet endof a tracheotomy tube inner cannula 11 to the outlet port of an in-linecatheter (not shown). The cannula 11 has a soft inner liner 12 and ahard outer case 13 which terminate at a relatively thick inlet face 14.The connector 10 has an elongated, flexible, accordion-like tubular body15. The catheter entry end 16 of the tubular body is adapted to beserially coupled in pneumatic communication with the catheter outletport (not shown). The catheter exit end 17 of the tubular body 15 isadapted to be serially coupled in pneumatic communication with the inletend of the tracheotomy tube inner cannula 11. The entry and exit ends 16and 17 of the connector body 15 are fitted with hard sleeves 18 and 19with outer annular flanges 21 and 22, respectively. The sleeves 18 and19 and flanges 21 and 22 are helpful in manipulating the connector 10which, by reason of its size and configuration and its contact duringuse with fluids which make its surface extremely slippery, can be quiteawkward.

As best seen in FIG. 1, the tip 23 of the catheter 24 has been insertedserially into the entry end 16, body 15 and exit end 17 of the connector10 until the tip 23 is in close proximity to the inlet face 14 of theinner cannula 11. As shown, even when the connector 10 is perfectlyaligned along its longitudinal axis 25, the catheter 24 tends to bowunder its own weight so that, as best seen in FIG. 2, the tip 23 atleast partially aligns longitudinally with the entry face 14 of theinner cannula 11. Further insertion of the catheter 24 into theconnector 10 will cause the tip 23 to “hang up” on the cannula face 14,blocking passage of the catheter 24 into the cannula 11 and initiatingthe sequence of undesirable events and consequences hereinbeforediscussed. Considering that the intended purpose of the design of theconnector 15 is to permit it to be stretched, compressed and bent andthat the catheter 24 must also be sufficiently flexible to travel asomewhat tortuous path, it is unlikely that the catheter tip 23 will not“hang up” on the cannula face 14, as has been evidenced in practice formany years.

Looking now at FIGS. 3-5, a preferred embodiment of a flexible connector30 according to the invention is illustrated. The new flexible connector30, like its predecessor connector 10, has an elongated, flexible,accordion-like tubular body 35 with its catheter entry end 36 and itscatheter exit end 37 adapted to be serially coupled in pneumaticcommunication with the catheter outlet port (not shown) and with theinlet end of the tracheotomy tube inner cannula 11 seen in FIGS. 1 and2, respectively. However, the catheter exit end 37 of the body 35 ismodified to guide the downstream tip 23 of the catheter 24 into theinlet end of the inner cannula 11 in response to pushing of the catheter24 at a point upstream of the catheter outlet port (not shown).

In the preferred embodiment of the connector 30 shown, and following thecontour of the catheter exit end 37 of the body 35 in a downstreamdirection, a taper 41 expands the exit end 37 to a maximum outerdiameter 43 greater than outer diameter 26 of the entry end of the innercannula 11, as seen in FIG. 1. The maximum outer diameter 43 is thencontracted to form an annular stop 45 on the outer surface of the exitend 37, the outer diameter 47 of the exit end 37 being substantiallyequal to the outer diameter 26 of the entry end of the inner cannula 11.The exit end 37 then has a gradual taper 49 to an inner diameter 51which is substantially equal to the inner diameter 27 of the entry face14 of the inner cannula 11. The exit end 37 of the connector 30 thenradially expands to an inner diameter 53 substantially equal to theouter diameter 26 of the entry end of the inner cannula 11, forming aflat downstream wall 55 of thickness 57 substantially equal to thethickness 28 of the inner cannula entry face 14, as seen in FIG. 1. Theexit end 37 of the connector 30 extends downstream from the wall 55 at aconstant inner diameter 53 and terminates at an annular rim 59.

Looking at FIGS. 6-8, the entry end 36 of the connector 30 is similar inall respects to the entry end 16 of the known connector 10 seen inFIG. 1. Its inner diameter 61 is sized to receive the downstream end ofthe outlet port of the catheter housing (not shown). Its outsidediameter 63 is sized to be inserted into the entry hard sleeve 18 and anannular stop 65 is positioned on its outer surface to engage an annularseat 29 in the sleeve 18. The seat 29 and stop 65 are positioned toprevent axial motion of the sleeve 18 on the connector 30 when thedownstream end of the sleeve 18 abuts the proximal accordion surface ofthe body 35.

Continuing to look at FIGS. 6-8, the downstream portion of the exit end37 of the connector 30 defined by the constant inner diameter 53 and thewall 55 form a cup 67 for receiving the entry end of the inner cannula11. The inner cannula 11 is inserted into the cup 67 until the cannulaentry face 14 abuts the connector wall 55. When the catheter 24 isinserted serially into the entry end 36, body 35 and exit end 37 of theconnector 30 until the tip 23 is in close proximity to the inlet face 14of the inner cannula 11, the gradual taper 49 leading up to the cup 67guides the downstream tip 23 of the catheter 24 into the inlet end ofthe inner cannula 11 in response to further pushing of the catheter 24from a position upstream of the catheter outlet port (not shown), as isbest seen FIG. 7. Thus, when the cannula face 14 and the connector wall55 are in abutment, the catheter tip 23 cannot “hang up” on the entryface 14 of the inner cannula 11, as is best seen in FIG. 8. This is truewhether the connector 30 is straight, stretched, compressed or bent.

Turning to FIG. 9, the outer diameters 47 and 69 at the stop 45 and ofthe cup 67, respectively, are substantially equal. Therefore, the hardsleeve 19 can be fitted on these constant diameter portions and used tomanipulate the exit end 37 of the connector 30 even though the gradualtaper 49 creates an annular void 71 between the connector 30 and thehard sleeve 19.

The connector 30 has been described in relation to an inner cannula 11of a tracheotomy tube having inner and outer cannulae. Some tracheotomytubes have a single cannula which, for purposes of using the modifiedcannula 30, may be considered as the inner cannula herein discussed.

Thus, it is apparent that there has been provided, in accordance withthe invention, a flexible connector that fully satisfies the objects,aims and advantages set forth above. While the invention has beendescribed in conjunction with a specific embodiment thereof, it isevident that many alternatives, modifications and variations will beapparent to those skilled in the art and in light of the foregoingdescription. Accordingly, it is intended to embrace all suchalternatives, modifications and variations as fall within the scope ofthe appended claims.

1. For coupling the inlet end of a tracheotomy tube inner cannula to anoutlet port of an in-line catheter, a connector comprising: anelongated, flexible, accordion-like tubular body; means on a catheterentry end of said tubular body for serially coupling said body inpneumatic communication with the catheter outlet port; means on acatheter exit end of said tubular body for serially coupling said bodyin pneumatic communication with the inlet end of the tracheotomy tubeinner cannula; and means on said body-to-cannula coupling means forguiding a downstream tip of the catheter into the inlet end of the innercannula in response to pushing the catheter at a location upstream ofthe catheter outlet port.
 2. A connector according to claim 1, saidguiding means comprising a gradual taper in a downstream direction, saidtaper having an inner diameter at its upstream end substantially equalto an outer diameter of the inlet end of the inner cannula and an innerdiameter at its downstream end not greater than an inner diameter of theinlet end of the inner cannula. 3-7. (canceled)
 8. For coupling an inletend of a tracheotomy tube inner cannula to an outlet port of an in-linecatheter, a connector comprising: an elongated, flexible, tubular body;and a catheter exit end of said tubular body having a first contourshaped to serially couple said tubular body in pneumatic communicationwith the inlet end of the tracheotomy tube inner cannula and a secondcontour shaped to guide a downstream tip of the catheter out of saidtubular body into the inlet end of the inner cannula in response topushing of the catheter at a location upstream of the catheter outletport.
 9. A connector according to claim 8, said second contourcomprising a gradual taper in a downstream direction, said taper havingan inner diameter at its downstream end not greater than an innerdiameter of the inlet end of the inner cannula.
 10. A connectoraccording to claim 9, said first contour comprising a flat wall about adownstream end of said gradual taper, said wall having a thicknesssubstantially equal to a thickness of an entry end face of the innercannula.
 11. A connector according to claim 10 further comprising aportion of constant diameter extending downstream from said flat walland cooperable with said flat wall to form a cup for receiving the inletend of the inner cannula.
 12. A connector according to claim 11 furthercomprising a bearing portion having an outer diameter substantiallyequal to an outer diameter of said cup extending upstream from saidupstream end of said gradual taper.
 13. A connector according to claim12 further comprising a hard sleeve concentrically disposed about andspanning across said bearing portion and said cup and creating a voidbetween said sleeve and the connector.
 14. A connector according toclaim 13 further comprising a radial expansion at an upstream end ofsaid bearing portion and an annular rim on a downstream end of said cup,said radial expansion and said rim being cooperable to preventlongitudinal motion of said sleeve on the connector.